{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:08:12Z","timestamp":1792001292164,"version":"4.4.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Introduction: There is increasing development of antibiotic resistance among the Enterococcus species. Objectives: This study was performed to determine prevalence and characterize the vancomycin-resistant and linezolid-resistant enterococcus isolates from a tertiary care center. Moreover, the antimicrobial susceptibility pattern of these isolates was also determined. Materials and Methods: A prospective study was performed in Medical College, Kolkata, India, over a period of two years (from January 2018 to December 2019). After obtaining clearance from the Institutional Ethics Committee, Enterococcus isolates from various samples were included in the present investigation. In addition to the various conventional biochemical tests, the VITEK 2 Compact system was used to identify the Enterococcus species. The isolates were tested for antimicrobial susceptibility to different antibiotics using the Kirby\u2013Bauer disk diffusion method and VITEK 2 Compact to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines were used to interpret susceptibility. Multiplex PCR was performed for genetic characterization of the vancomycin-resistant Enterococcus isolates and sequencing was performed for characterization of the linezolid-resistant Enterococcus isolates. Results: During the period of two years, 371 isolates of Enterococcus spp. were obtained from 4934 clinical isolates showing a prevalence of 7.52%. Among these isolates, 239 (64.42%) were Enterococcus faecalis, 114 (30.72%) Enterococcus faecium, and others were Enterococcus\u00a0durans, Enterococcus\u00a0casseliflavus, Enterococcus\u00a0gallinarum, and Enterococcus\u00a0avium. Among these, 24 (6.47%) were VRE (Vancomycin-Resistant Enterococcus) of which 18 isolates were Van A type and six isolates of Enterococcus\u00a0casseliflavus and Enterococcus\u00a0gallinarum were resistant VanC type. There were two linezolid-resistant Enterococcus, and they were found to have the G2576T mutation. Among the 371 isolates, 252 (67.92%) were multi-drug resistant. Conclusion: This study found an increasing prevalence of vancomycin-resistant Enterococcus isolates. There is also an alarming prevalence of multidrug resistance among these isolates.<\/jats:p>","DOI":"10.3390\/diagnostics13050945","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T03:54:56Z","timestamp":1677729296000},"page":"945","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Vancomycin and Linezolid-Resistant Enterococcus Isolates from a Tertiary Care Center in India"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1246-4334","authenticated-orcid":false,"given":"Mallika","family":"Sengupta","sequence":"first","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Kalyani 741245, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2051-9120","authenticated-orcid":false,"given":"Riya","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Vijaya Diagnostics Laboratory, Hyderabad 500029, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soma","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, NRS Medical College, Kolkata 700014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manideepa","family":"Sengupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical College, Kolkata 700073, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sougata","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical College, Kolkata 700073, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parthajit","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Microbiology, KPC Medical College, Kolkata 700032, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1128\/CMR.3.1.46","article-title":"The life and times of the Enterococcus","volume":"3","author":"Murray","year":"1990","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","first-page":"768","article-title":"Vancomycin resistant Enterococci: A brief review","volume":"68","author":"Raza","year":"2018","journal-title":"JPMA J. Pak. Med. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"483","DOI":"10.4103\/0971-5916.159309","article-title":"Antimicrobial susceptibility pattern of vancomycin resistant enterococci to newer antimicrobial agents","volume":"141","author":"Gupta","year":"2015","journal-title":"Indian J. Med. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5857","DOI":"10.1128\/JCM.42.12.5857-5860.2004","article-title":"Detection of the van alphabet and identification of enterococci and staphylococci at the species level by multiplex PCR","volume":"42","author":"Depardieu","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"357","DOI":"10.4103\/0971-5916.182627","article-title":"Emergence of vanA gene among vancomycin-resistant enterococci in a tertiary care hospital of North-East India","volume":"143","author":"Phukan","year":"2016","journal-title":"Indian J. Med. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.4103\/0971-5916.178619","article-title":"Drug resistance in Enterococcus species in a tertiary level hospital in Assam, India","volume":"143","author":"Barman","year":"2016","journal-title":"Indian J. Med. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/2231-0770.127416","article-title":"The first linezolid-resistant Enterococcus faecium in India: High level resistance in a patient with no previous antibiotic exposure","volume":"4","author":"Kumar","year":"2014","journal-title":"Avicenna J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1086\/528867","article-title":"Pandrug Resistance (PDR), Extensive Drug Resistance (XDR), and Multidrug Resistance (MDR) among Gram-Negative Bacilli: Need for International Harmonization in Terminology","volume":"46","author":"Falagas","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Uru\u00e9n, C., Chopo-Escuin, G., Tommassen, J., Mainar-Jaime, R.C., and Arenas, J. (2020). Biofilms as Promoters of Bacterial Antibiotic Resistance and Tolerance. Antibiotics, 10.","DOI":"10.3390\/antibiotics10010003"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1128\/MMBR.00013-14","article-title":"Biofilm-related infections: Bridging the gap between clinical management and fundamental aspects of recalcitrance toward antibiotics","volume":"78","author":"Lebeaux","year":"2014","journal-title":"Microbiol. Mol. Biol. Rev. MMBR"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/j.idc.2016.07.009","article-title":"Vancomycin-Resistant Enterococci: Epidemiology, Infection Prevention, and Control","volume":"30","author":"Reyes","year":"2016","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/1099800416654013","article-title":"Chlorhexidine Bathing Effects on Health-Care-Associated Infections","volume":"19","author":"Denny","year":"2017","journal-title":"Biol. Res. Nurs."},{"key":"ref_13","unstructured":"Clinical & Laboratory Standards Institute (2022, August 10). CLSI in 2017 [Internet]. Available online: https:\/\/clsi.org\/2017\/."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.mjafi.2014.03.005","article-title":"Detection of glycopeptide resistance genes in enterococci by multiplex PCR","volume":"71","author":"Bhatt","year":"2015","journal-title":"Med. J. Armed Forces India"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"394","DOI":"10.4103\/0976-9668.160018","article-title":"Antibiotic resistance pattern of Enterococci isolates from nosocomial infections in a tertiary care hospital in Eastern India","volume":"6","author":"Chakraborty","year":"2015","journal-title":"J. Nat. Sci. Biol. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3484","DOI":"10.18203\/2320-6012.ijrms20173546","article-title":"Characterization, speciation and antimicrobial resistance pattern of Enterococcus species isolated from clinical specimens at a rural tertiary care hospital","volume":"5","author":"Jaiswal","year":"2017","journal-title":"Int. J. Res. Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1086\/320542","article-title":"Clinical and Epidemiological Features of Enterococcus casseliflavus\/flavescens and Enterococcus gallinarum Bacteremia: A Report of 20 Cases","volume":"32","author":"Reid","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jiac.2018.01.001","article-title":"Clinical management of non-faecium non-faecalis vancomycin-resistant enterococci infection. Focus on Enterococcus gallinarum and Enterococcus casseliflavus\/flavescens","volume":"24","author":"Monticelli","year":"2018","journal-title":"J. Infect. Chemother. Off. J. Jpn. Soc. Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.mjafi.2014.08.007","article-title":"Emergence of multidrug resistant enterococci at a tertiary care centre","volume":"71","author":"Bhatt","year":"2015","journal-title":"Med. J. Armed Forces India"},{"key":"ref_20","first-page":"549","article-title":"Phenotypic & genotypic characterization of vancomycin resistant Enterococcus isolates from clinical specimens","volume":"138","author":"Praharaj","year":"2013","journal-title":"Indian J. Med. Res."},{"key":"ref_21","first-page":"981","article-title":"Drug resistance & virulence determinants in clinical isolates of Enterococcus species","volume":"137","author":"Fernandes","year":"2013","journal-title":"Indian J. Med. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.idc.2020.08.004","article-title":"Resistance in Vancomycin-Resistant Enterococci","volume":"34","author":"Miller","year":"2020","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1007\/s10096-016-2702-0","article-title":"Prevalence of vancomycin-resistant Enterococcus in Iran: A systematic review and meta-analysis","volume":"35","author":"Emaneini","year":"2016","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Melese, A., Genet, C., and Andualem, T. (2020). Prevalence of Vancomycin resistant enterococci (VRE) in Ethiopia: A systematic review and meta-analysis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-4833-2"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4103\/0377-4929.182015","article-title":"Detection of vancomycin resistance in enterococcus species isolated from clinical samples and feces of colonized patients by phenotypic and genotypic methods","volume":"59","author":"Biswas","year":"2016","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"231","DOI":"10.4103\/0974-777X.68534","article-title":"High-level Aminoglycoside Resistance and Reduced Susceptibility to Vancomycin in Nosocomial Enterococci","volume":"2","author":"Adhikari","year":"2010","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3424","DOI":"10.3390\/ijerph110303424","article-title":"Prevalence and antimicrobial resistance of Enterococcus species: A hospital-based study in China","volume":"11","author":"Jia","year":"2014","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_28","first-page":"368","article-title":"Fosfomycin Susceptibility in Multidrug-Resistant Enterobacteriaceae Species and Vancomycin-Resistant Enterococci Urinary Isolates","volume":"70","author":"Ou","year":"2017","journal-title":"Can. J. Hosp. Pharm."},{"key":"ref_29","first-page":"281","article-title":"In vitro efficacy of vancomycin combined with fosfomycin against Vancomycin-Resistant Enterococci strains","volume":"36","author":"Aktas","year":"2020","journal-title":"Pak. J. Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3049","DOI":"10.2147\/DDDT.S315061","article-title":"In vitro Antimicrobial Activity of Fosfomycin, Rifampin, Vancomycin, Daptomycin Alone and in Combination Against Vancomycin-Resistant Enterococci","volume":"15","author":"Tong","year":"2021","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.ijantimicag.2013.11.003","article-title":"Fosfomycin resistance among vancomycin-resistant enterococci owing to transfer of a plasmid harbouring the fosB gene","volume":"43","author":"Qu","year":"2014","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1089\/mdr.2019.0044","article-title":"Susceptibility of Nitrofurantoin and Fosfomycin Against Outpatient Urinary Isolates of Multidrug-Resistant Enterococci over a Period of 10 Years from India","volume":"26","author":"Das","year":"2020","journal-title":"Microb. Drug Resist."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1556\/030.65.2018.046","article-title":"High prevalence of vancomycin and high-level gentamicin resistance in Enterococcus faecalis isolates","volume":"66","author":"Taji","year":"2019","journal-title":"Acta Microbiol. Immunol. Hung."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Haghi, F., Lohrasbi, V., and Zeighami, H. (2019). High incidence of virulence determinants, aminoglycoside and vancomycin resistance in enterococci isolated from hospitalized patients in Northwest Iran. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4395-3"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/5\/945\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:45:55Z","timestamp":1760121955000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/5\/945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["diagnostics13050945"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13050945","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,2]]}}}